FDA Adverse Event Malfunction Summary report: N

GZ-130P

MDR report key: 17801189 · Received September 22, 2023

Report

Report Number
8030229-2023-03769
Event Type
Malfunction
Date Received
September 22, 2023
Date of Event
August 24, 2023
Report Date
August 12, 2024
Manufacturer
NIHON KOHDEN CORPORATION
Product Code
MHX
UDI-DI
04931921117415
PMA / PMN Number
K153707
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE BIOMEDICAL ENGINEER REPORTED THAT THE TELEMETRY TRANSMITTER (TELE) IS CONSTANTLY REBOOTING. THEY HAVE ALREADY TRIED TO TROUBLESHOOTING THE UNIT AND WAS UNABLE TO RESOLVE THE ISSUE. NO PATIENT HARM WAS REPORTED. NIHON KOHDEN CONTINUES TO INVESTIGATE THE REPORTED EVENT. NIHON KOHDEN WILL SUBMIT A SUPPLEMENTAL REPORT IN ACCORDANCE WITH 21 CFR SECTION 803.56 WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE.

Additional Manufacturer Narrative · 0

UDI RELATED DATA QUALITY UPDATES ONLY: D1 BRAND NAME: CORRECTED THE BRAND NAME FROM GZ-130PA TO GZ-130P. D2B PRODUCT CODE: CORRECTED THE PRODUCT CODE FROM DRT TO MHX. D4 ADDITIONAL DEVICE INFORMATION / MODEL #: CORRECTED THE MODEL # FROM GZ-130PA TO GZ-130P. D4 ADDITIONAL DEVICE INFORMATION / CATALOG #: CORRECTED THE CATALOG # FROM GZ-130PA TO GZ-130P. D4 ADDITIONAL DEVICE INFORMATION / PRIMARY UNIQUE DEVICE IDENTIFIER (UDI) #: CORRECTED THE UDI # TO INCLUDE THE PRODUCTION IDENTIFIER (PI) INFORMATION. THIS IS A CORRECTION TO THE SUSPECT MEDICAL DEVICE INVOLVED IN THE REPORTED EVENT, SPECIFICALLY THE UNIQUE DEVICE IDENTIFIER (UDI) INFORMATION IN SECTION D OF THE FDA FORM 3500A, PER THE FDA REQUEST.

Additional Manufacturer Narrative · 0

DETAILS OF THE COMPLAINT: THE BIOMEDICAL ENGINEER REPORTED THAT THE TELEMETRY TRANSMITTER (TELE) IS CONSTANTLY REBOOTING. THEY HAVE ALREADY TRIED TO TROUBLESHOOTING THE UNIT AND WAS UNABLE TO RESOLVE THE ISSUE. NO PATIENT HARM WAS REPORTED. INVESTIGATION CONCLUSION: THE COMPLAINT UNIT WAS RETURNED AND WAS EVALUATED. THE DEVICE WAS NOT TURNING ON. NK REPAIR CENTER WAS UNABLE TO OBSERVE THE CONSTANT REBOOT ISSUE DUE TO THE DEVICE NOT TURNING ON. THE BATTERIES OF THE DEVICE WERE REPLACED BUT THE DEVICE WOULD STILL NOT TURN ON. NK REPAIR CENTER NOTED THAT THE BATTERY PORT HAS "HEAVY CORROSION". THE CORROSION AT THE BATTERY PORT IS LIKELY CAUSING THE CONSTANT REBOOT AND POWER ISSUES ON THE DEVICE. THE CORROSION ON THE BATTERY PORT IS LIKELY CAUSED BY FLUID INTRUSION. RESIDUAL MOISTURE ON THE DEVICE COULD HAVE DRIED UP AND HAD CAUSED THE CORROSION OF THE BATTERY PORT. PER OPERATOR'S MANUAL OF THE DEVICE, THE DEVICE IS WATERPROOF BUT THE BATTERY CASE, ELECTRODE LEAD, AND SPO2 PROBE ARE NOT WATERPROOF.

Description of Event or Problem · 0

THE BIOMEDICAL ENGINEER REPORTED THAT THE TELEMETRY TRANSMITTER (TELE) IS CONSTANTLY REBOOTING. THEY HAVE ALREADY TRIED TO TROUBLESHOOTING THE UNIT AND WAS UNABLE TO RESOLVE THE ISSUE. NO PATIENT HARM WAS REPORTED.

Description of Event or Problem · 0

THE BIOMEDICAL ENGINEER REPORTED THAT THE TELEMETRY TRANSMITTER (TELE) IS CONSTANTLY REBOOTING. THEY HAVE ALREADY TRIED TO TROUBLESHOOTING THE UNIT AND WAS UNABLE TO RESOLVE THE ISSUE. NO PATIENT HARM WAS REPORTED.

Description of Event or Problem · 0

THE BIOMEDICAL ENGINEER REPORTED THAT THE TELEMETRY TRANSMITTER (TELE) IS CONSTANTLY REBOOTING. THEY HAVE ALREADY TRIED TO TROUBLESHOOTING THE UNIT AND WAS UNABLE TO RESOLVE THE ISSUE. NO PATIENT HARM WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1295304 GZ-130P TRANSMITTER MHX NIHON KOHDEN CORPORATION GZ-130P NA 04931921117415
2333890 GZ-130P TRANSMITTER MHX NIHON KOHDEN CORPORATION GZ-130P NA 04931921117415

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown CENTRAL NURSE'S STATION.| CENTRAL NURSE'S STATION.| CENTRAL NURSE'S STATION.